阿立哌唑、利培酮及氯丙嗪对精神分裂症疗效及认知功能的影响

目的探讨非经典抗精神病药阿立哌唑、利培酮及传统抗精神病药氯丙嗪治疗精神分裂症的疗效及对认知功能的影响。方法将148例符合CCMD-3诊断标准的精神分裂症病人随机分为阿立哌唑组（48例）、利培酮组（52例）和氯丙嗪组（48例），观察12周，分别于治疗前及治疗后4、8、12周采用阳性症状与阴性症状量表（PANSS）、不良反应量表（TESS）评定疗效和不良反应；治疗前及治疗后12周采用韦氏成人记忆测检（WMS）及威斯康星卡片分类测验（WCST）测定。结果与治疗前比较，三组治疗后12周PANSS总分及各因子分显著下降（P〈0．01），但三组之间无显著差异；利培酮、氯丙嗪组的不良反应发生率高于阿立哌唑组（P〈0．05），主要表现为肌强直、震颤等锥体外系等不良反应；阿立哌唑、利培酮组WMS和WCST评分均有显著改善，而氯丙嗪组治疗前后则无差异。结论阿立哌唑、利培酮及氯丙嗪治疗精神分裂症均有效，且疗效相当，阿立哌唑所致锥体外系不良反应较少，阿立哌唑、利培酮对认知功能有改善作用，而氯丙嗪则对认知功能无影响。

A controlled study of the efficacy and effect of aripiprazole, risperidone and chlorpromazine on cognitive function in schizophrenic patients

Objective To examine the efficacy and effect of aripiprazole, risperidone and chlorpromazine on cognitive function in the treatment of schizophrenic patients. Methods 148 schizophrenic patients were assigned to receive aripiprazole, risperidone and chlorpromazine treatment for 12 weeks, and the positive and negtive syndrome scale （PANSS）, treatment emergent symptoms scale（TESS）,Wechsler memory scale（WMS） and Wisconsin card sorting test（WCST） were used to measure therapeutic efflcacy,side effects and cognitive fimction. Results The total scores and factors scores of PANSS decreased significantly after aripiprazole, risperidone and chlorpromazine treatment （P 〈 0. 01 ）. No significant difference was found on the scores of PANSS among aripiprazole group, risperidone group and chlorpmmazine treatment group. The side effects,such as myotone and tremor,were higher in risperidone and chlorpromazine treatment groups than in aripiprazole treatment group after receiving treatment. The WMS and WCST scores increased significantly after aripiprazole and chlorpromazine treatment. Conclusion Aripiprazole, risperidone and chlorpromazine were effective in the treatment of schizophrenia, and risperidone has less side effects.Aripiprazole and risperidone can improve cognitive impairment of patients with schizophrenia.